Increased myocardial methionine-enkephalin with reduced arterial oxygenation in congenital heart disease
Article first published online: 7 JUL 2010
© 2010 The Authors. Journal compilation © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 50, Issue 10, pages E63–E67, October 2014
How to Cite
van den Brink, O. W., Cochrane, A. D., Rosenfeldt, F. L., Penny, D. J. and Pepe, S. (2014), Increased myocardial methionine-enkephalin with reduced arterial oxygenation in congenital heart disease. Journal of Paediatrics and Child Health, 50: E63–E67. doi: 10.1111/j.1440-1754.2010.01794.x
- Issue published online: 6 OCT 2014
- Article first published online: 7 JUL 2010
- Accepted for publication 11 January 2010.
- congenital heart defects;
- opioid peptide;
- tetralogy of Fallot
Background: Cardiac opioid peptides have been identified to exert important adaptive metabolic signalling for cardioprotection against ischaemia or hypoxia-related injury.
Aims: To determine myocardial methionine-enkephalin content in children with hypoxemic congenital heart defects and to correlate myocardial content of methionine-enkephalin with the extent of arterial oxygen desaturation.
Methods: Children (n= 20, median age of 16 months), undergoing cardiac surgical repair (tetralogy of Fallot, 17/20), were included in this study. Arterial oxygen saturation was measured on admission. Myocardial samples obtained during surgery were assayed via radioimmunochemistry for methionine-enkephalin content.
Results: Greater methionine-enkephalin content was measured in the right ventricles of the patients suffering from recent cyanotic spells compared with those with no recent spells (cyanotic spells: 2418 ± 844 pg/g wet weight tissue, n= 6; no spells: 1175 ± 189 pg/g wet weight tissue, n= 14, P= 0.04). An inverse correlation was evident between the arterial oxygen saturation and myocardial methionine-enkephalin content.
Conclusion: Myocardial methionine-enkephalin levels increase with the severity of hypoxic stress in congenital cardiac disease and may play an important adaptive role in countering adrenergic over-activity and related excess demand on myocardial metabolic capacity.